Should I have a hysterectomy to avoid gynecologic cancers?

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If a woman has already had breast cancer, wouldn't it make sense to have a hysterectomy to avoid getting other female types of cancer, i.e. ovarian and uterine cancer? I am currently 52 years old. Thank you.

Christina S. Chu, MD, Assistant Professor of the Division of Gynecologic Oncology at the University of Pennsylvania Health System, responds:

Patients with hereditary breast cancer (due to genetic mutations in the BRCA1 or BRCA2 genes) may benefit from removal of the fallopian tubes and ovaries. Patients with mutations in these genes are at increased risk of breast cancer as well as of cancers of the fallopian tubes and ovaries. Preventative surgery to remove these organs may decrease the risk of recurrent breast cancer by up to 40%, and may almost eliminate the risk of fallopian tube and ovarian cancers.

Most women with breast cancer or ovarian cancer, however, do not have hereditary tumors, and are not necessarily at increased risk of other pelvic tumors just because they suffer from breast cancer. It is not clear that prophylactic surgery is warranted in these cases.

Mar 18, 2010 - The decision to perform prophylactic bilateral oophorectomy at the same time as hysterectomy should be taken with caution as it may do more harm than good, especially in women not at high risk for development of ovarian or breast cancers, according to a review published in the March issue of the Journal of Minimally Invasive Gynecology.